Our Provider’s Blog

Excerpts from the Medical Director

CHRONIC RECTAL OR PELVIC PAIN As we have discussed in previous articles, there are 3 common causes of rectal pain. THROMBOSED HEMORRHOIDS, FISSURES, AND ABCESSES. There are a number of causes of less significant irritation such as pruritus, skin tags, and anything else that can irritate the skin.

The least common cause of pain falls in the category of something we call Levator Syndrome/Spastic Levator/Pelvic Floor syndrome, or Chronic Proctalgia. Proctalgia literally translates to ‘rectal pain’. This can be intermittent discomfort which occurs over a matter of a few minutes and dissipates just as quickly, typically occurring at night, and called Proctalgia Fugax ( fleeting pain in the rectum ); or more chronic pain which can last days, weeks or in some cases many years. We refer to this more chronic discomfort as Levator or Pelvic floor syndrome. Although this has been related to pelvic surgery, or certain jobs requiring prolonged sitting or maintaining certain positioning, my experience has been that most often I can find no obvious cause! I have in fact seen it in a patient who had no rectum, it having been removed for inflammatory bowel disease many years before. Though we often use the term rectal to describe the pain, it is in fact in the muscles of the pelvic floor and the sphincter muscles. Examination will show no abnormalities on anorectal exam and colonoscopy. The diagnosis is made by eliciting pain on rectal exam within the sphincter and levator muscles of the pelvic floor. It is most often more severe on the left side.

Treatment can be difficult but is successful in most patients. It consists of warm sitz baths to relax and sooth the muscles. Physical Therapy including Kegel exercises and quite often Physical Therapy referral for more specialized treatment. If these measures alone are not effective, medicines such as Elavil ( amitriptyline ) can be used in low doses to bring about relief of pain. Though it is a benign disease it can be quite bothersome to patients. It is important when treating to remind patients that although it can take time, the majority of patients will get relief of their pain.

If you are suffering rectal pain, change in bowel pattern, rectal bleeding, or any colonic symptom…seek the advice of a Colorectal Surgeon! Remember, patients treated by Colorectal Surgeons have better outcomes. WWW.colondocs.net


Colorectal cancer is the second most common cancer overall in the U.S. There are approximately 140,000 new cases diagnosed yearly; with 50,000 to 60,000 deaths! The risk of developing colon cancer increases with age; especially after the age of 45- 50. Cancer develops from polyps which are abnormal growths from the lining of the colon. It takes a number of years ( 3-5yrs or longer ) for a polyp to grow and undergo the change from benign to cancerous. This gives us the opportunity to examine the colon and remove polyps before they become cancerous. This is the reason that we recommend that everyone begin colon cancer screening by age 45-50 and continue screening every 10 years for life. Patients with a family history of cancer or polyps should begin screening at age 40 or ten years earlier than detection of the poly or cancer in their family member, and continue screening every 5 years. Colonoscopy is a painless procedure in almost all cases; being done under sedation or anesthesia. It is entirely normal to be apprehensive or afraid of any procedure. If you have questions or wish to schedule a colonoscopy don’t hesitate to call us. Our Board Certified Colorectal Surgeons can safely guide you through the entire process and procedure.

The primary treatment of colorectal cancer is surgery.

Patients treated by Colorectal Surgeons have better outcomes.


Fecal Incontinence affects 1 in 12, or currently 20 million adults in America on a daily basis. TriState Colorectal is proud to offer the new Fecal Incontinence Center, where patients can meet the surgeon, go through evaluation and testing in our office, and ultimately determine the best treatment- sometimes non surgical and other times surgical options are best.

Yesterday, Dr Matheson was the first surgeon in the Tri State area to implant the new, smallest and fastest rechargeable sacral nerve modulator. This technology will continue to help our patients take back control and live life their way! Call today for your appointment to start on the path to regaining control and living life your way!!!

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